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PubMed1993

Amniotic band syndrome: a population-based study in two Australian states.

A search for cases of amniotic band syndrome was made in two population-based Australian birth defects registries, using defined selection criteria. Over a period of 4 years in Western Australia and 5 years in South Australia, 25 cases of amniotic band syndrome had been identified as such by the two registries, and an additional 15 new cases were identified by the study selection process, giving an annual prevalence of amniotic band syndrome over the study period of 2.03 per 10,000 births. Similar proportions of male and female infants were affected, although the syndrome was more common in mothers younger than 25 years of age, and in first births. Limb defects only (upper and/or lower) were found in 24 cases, limb-body-wall defects in four cases, and complex craniofacial and other malformations in 12 cases. A heightened awareness of the syndrome should enhance the identification of amniotic band syndrome, which has implications for genetic counselling, and our understanding of the aetiology and pathogenesis of this condition.

Amniotic Band Syndrome↗
PubMed1986

[Age, parity, and time in fertility].

The authors analyze fertility trends in Japan from 1935 to 1969 using "vital statistics data upon which age-parity adjusted net reproduction tables were constructed for 35 different female birth cohorts." These tables are used to calculate "cohort net reproduction rate and total fertility rate by parity and age, [as well as] mean age at first birth, second birth, etc. and average length of birth interval in each cohort." (summary in ENG)

Age Factors↗
PubMed1978

Sex of first child as a prognostic factor in breast cancer.

The sex of the first child of patients who underwent mastectomy for potentially curable breast cancer appeared to be a valuable prognostic factor: patients whose first child was a boy had a better outcome than those whose first child was a girl. The difference was statistically significant. This may have been because the male/female sex ratio among first children was significantly higher in those patients without node involvement than in those with node involvement. But the favourable effect of a male first birth was still seen when only patients with an equal degree of node involvement (greater than or equal to 4 nodes) were studied. The "protection" resulting from a male first-born could be the result of fetal testicular secretions. This protection did not apply to the risk of breast cancer--the male/female sex ratio of first children in our series was 1.08, a figure not statistically different from that of the overall French population (1.05).

Birth Order↗
PubMed1987

General epidemiology of breast cancer in northern Italy.

The role of the major identified risk factors for breast cancer was assessed using data from a hospital-based case-control study conducted in Northern Italy on 1108 women with histologically confirmed breast cancer and 1281 control subjects with a spectrum of acute conditions unrelated to any of the established or potential risk factors for breast disease. With reference to nulliparous women, the risk of breast cancer was below unity for those who first gave birth below age 25, and above unity for those with later first full-term pregnancy. However, in each stratum of age at first birth, the point estimate was below unity for women with five or more births. The relative risk for greater than or equal to 5 births compared with 1 or 2 was 0.6 (95% confidence interval = 0.4-0.9) when allowance was made for age at first birth. Likewise, there was a significant and independent effect of age at last birth which was evident in various strata of parity and age at first birth. The overall relative risk for last birth at 30 years or over compared with under 30 was 1.4 (95% confidence interval = 1.1-1.8). There was little relation of breast cancer risk with abortions or miscarriages. Breast cancer cases reported earlier menarche and later menopause; further, lifelong irregularities in menstrual pattern were less common among the cases (relative risk = 0.6, 95% confidence interval = 0.5-0.8). The risk estimates were elevated in women with positive history of benign breast disease, family history of breast cancer and greater body mass index.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMed2005

Previous pregnancy outcome and breast density (United States).

OBJECTIVE: We evaluated the association of pre-term delivery (PTD), low birth weight (LBW), and fetal death with breast density by age at mammogram and years since birth. METHODS: Subjects were women aged < or =55 years who had a screening mammogram between 1 June 1996 and 1 August 1997 in Seattle, Washington, and whose records were linked to their previous state birth (1 January 1968 to 1 August 1997) or fetal death (1/1/1984-8/1/1997) records. We used unconditional logistic regression, adjusting for age at mammogram, body mass index, age at first birth, and menopausal status, to calculate the odds of dense (extremely or heterogeneously dense by BI-RADS) (n=3593) versus fatty breasts (scattered fibroglandular tissue or almost entirely fat) (n=2378) for women with a prior PTD (< 34, 34-36 versus > or =37 weeks gestation), LBW (< 2500 versus > or =2500 g), or fetal death (stillborn 20 weeks gestation versus live birth). RESULTS: The odds for denser breasts increased among women with PTD at <34 weeks gestation who were < or =45 years at time of mammogram (odds ratio (OR) and 95 confidence interval (CI)=2.8 (1.3-6.1)) and for whom <10 years had elapsed since pregnancy (OR=8.8 (1.7-45.8)). We observed similar increases in density among women with LBW (OR=3.3 (1.3-8.2)) when <10 years had elapsed. CONCLUSIONS: PTD and LBW may have a transitory effect on breast density.

Adult↗
PubMed1994

[Maternal mortality at the Tokoin Lome University Hospital Center from 1990 to 1992].

190 deaths of mothers per 24,668 deliveries with 21,603 live births were recorded at the Gynaecology-Obstetrics clinic of the CHU Tokoin hospital, Lome, between 1st January 1990 and 31st December 1992. Maternal mortality was estimated to be 379.5 per 100,000 live births and this incidence is increasing. The main risk factors are a low level of education, mothers less than 20 years or more than 35 years in age, first births and high multiparity. Referred patients were most frequently involved (148 deaths out of the 190 reported). The most frequent aetiological factors were haemorrhage (53 deaths), infection (50 deaths), anaemia (39 deaths) and preeclampsia (10 deaths). These factors reflect the shortcomings of the pre-natal monitoring and care provided in our health centres and hospitals. Improvement in the living conditions of women and a change in the health policy of the country could help to reduce maternal mortality rates.

Adult↗
PubMed2000

Sex, birth weight, and the risk of stillbirth in Scotland, 1980-1996.

The aim of this study was to determine whether the risk of stillbirth associated with male fetal sex was modified by fetal growth. The study group consisted of all singleton first births weighing greater than 500 g delivered between 28 and 43 weeks gestation in Scotland in 1980-1996 (n = 469,152). Overall, male fetuses were at an increased risk of stillbirth (relative risk = 1.19, 95 percent confidence interval: 1.10, 1.29). There was a significant negative interaction between male sex and increasing birth weight quintile in term, but not preterm, births. The interaction was virtually identical when calculated independently for births in the periods 1980-1987 and 1988-1996. There were linear decreases in the proportion of stillbirths and the proportion of birth weights in the lowest quintile over the period 1980-1996. Adjustment for year of birth did not affect the relation between male sex and stillbirth. However, adjustment for birth weight resulted in a loss of the association between year of birth and risk of stillbirth. The authors concluded that 1) the association between male sex and stillbirth diminishes with increasing birth weight quintile, and 2) there was a fall in the proportion of stillbirths in Scotland between 1980 and 1996, which may have been due to a fall in the proportion of small babies over the same period.

Birth Weight↗
PubMed2005

Parity, other reproductive factors, and risk of pancreatic cancer mortality in a large cohort of U.S. women (United States).

Several studies have found an inverse relationship between parity and risk of pancreatic cancer. However, most of the studies of pancreatic cancer in relation to parity and other reproductive factors have been small and the results inconsistent. Most recently, a well-conducted, prospective cohort study found a linear inverse association between parity and pancreatic cancer. To clarify the relationship between parity and other reproductive factors and risk of pancreatic mortality, we examined these associations among 387,981 postmenopausal U.S. women in the Cancer Prevention Study (CPS)-II cohort. CPS-II participants completed a self-administered questionnaire in 1982 and were followed for mortality through 2000. During follow-up, 1959 pancreatic cancer deaths occurred. Using Cox proportional hazards modeling, we calculated rate ratios (RR) adjusted for age, race, education, personal history of diabetes, body mass index, height, exercise, family history of pancreatic cancer, and cigarette smoking status, frequency, and duration. Overall, we did not observe a significant association between parity and pancreatic cancer mortality (trend p = 0.07). However, women who had five or more births had lower death rates from pancreatic cancer than nulliparous women (RR = 0.80, 95% CI = 0.66-0.96). We observed no association between any other reproductive factors examined (age at first birth, menarche, or menopause; type of menopause; diethylstilbestrol (DES) use; or duration of oral contraceptive or estrogen replacement therapy use) and pancreatic cancer mortality. In summary, our results support the observation that high parity is associated with lower risk of pancreatic cancer but do not show a linear trend with increasing parity. Furthermore, we find no evidence that other reproductive factors are associated with pancreatic cancer mortality.

Adult↗
PubMed1990

Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway.

A population-based case-control study was conducted in Sweden and Norway to analyse possible associations between breast cancer occurring before the age of 45 and several different characteristics of the women's reproductive life. A total of 422 (89.2%) of all eligible patients, and 527 (80.6%) of all eligible controls were interviewed. In univariate analyses, different characteristics of child-bearing (parity, age at first birth, years between last birth and diagnosis, duration of breast-feeding, and number of induced and spontaneous abortions), measures of the fertile or ovulating period (age at menarche, years between menarche and first pregnancy, and estimates of the menstruation span) and symptoms of anovulatory cycles or infertility were all seemingly unrelated to, or at most weakly associated with breast cancer. Adjustment for possible confounding factors in multivariate analyses resulted in largely unaltered risk estimates with odds ratios close to unity and without any significant trends when the exposure variables were studied in categorised or in continuous form. We conclude that reproductive factors did not explain the occurrence of breast cancer before the age of 45 in this population.

Abortion, Spontaneous↗
PubMed2007

Psychosocial adjustment during pregnancy for older couples conceiving through assisted reproductive technology.

BACKGROUND: The trend to older maternal age at first birth is well established in Western countries and biological risk factors, particularly declining fertility, are well documented. Less is known, however, about the psychosocial well-being of older first time parents. This study explores differences in psychosocial adjustment during pregnancy in older (maternal age >or= 38 years) and younger (maternal age < 35 years) couples after assisted reproductive technology (ART) conception. METHODS: Questionnaire data were collected from a consecutive cohort of pregnant nulliparous women and their partners recruited over a 12-month period from ART clinics in Sydney, Australia. RESULTS: There were more similarities than differences when comparing older and younger couples. Older couples took longer to conceive and were more likely to use donor eggs. Older pregnant women scored higher on a measure of psychological hardiness/resilience and reported a lower identification with motherhood compared with younger pregnant women. Older men differed only in reporting a less satisfying social orientation during pregnancy (lower satisfaction with sex life, relationship with partner and social life). CONCLUSIONS: Findings do not indicate problematic adjustment during pregnancy in older couples, but differences found need further investigation using larger samples and prospective designs.

Adult↗
PubMed1993

Maternal youth or family background? On the health disadvantages of infants with teenage mothers.

The health disadvantages of infants with teenage mothers are well documented. Because poor and minority women are disproportionately represented among teen mothers, differences in infant health by maternal age may reflect family background (pre-childbearing) characteristics rather than the effects of maternal age. To control for differences in family background, the authors compared birth outcomes and maternal behaviors that could affect fetal or infant health among sisters in the US National Longitudinal Survey of Youth (1979-1988). They compared sisters who had first births at different ages in order to study the relation between maternal age and low birth weight, prenatal care, smoking and alcohol use during pregnancy, breast feeding, and well-child visits. The authors found evidence that maternal family background accounts for many of the health-related disadvantages of the firstborn infants of teenage mothers. The findings suggest that disadvantaged black primiparous women in their twenties may be an important and possibly underemphasized target population for interventions designed to reduce excess black low birth weight and infant mortality rates.

Adolescent↗
PubMed1997

Developmental dysplasia of the hip in South Australia in 1991: prevalence and risk factors.

OBJECTIVE: To determine the prevalence of developmental dysplasia of the hip (DDH) in South Australia (SA) in 1991, the proportion of cases detected in the neonatal period and the perinatal risk factors for DDH. METHODOLOGY: Cases of DDH born in SA in 1991 were identified from multiple sources and their clinical data linked to perinatal data provided by midwives; five controls per case were obtained randomly from SA livebirths without congenital abnormalities and adjusted odds ratios (OR) for potential risk factors obtained by logistic regression analysis. South Australia perinatal data were also used to estimate numbers of births with perinatal risk factors for targeted screening. RESULTS: Two hundred and six cases of isolated DDH were identified, giving a prevalence of 10.5 per 1000 births. Of these, 173 (84%) had been detected in the neonatal period. The perinatal risk factors for DDH were identified as breech presentation (OR 9.65), female babies (OR 4.04), first births (OR 1.91) and maternal age of 25 years or more (OR 1.53). Screening breech and firstborn female babies (23% of births) would yield approximately 51% of cases of DDH. CONCLUSIONS: Isolated DDH had a prevalence of 10.5 per 1000 births and 84% of cases had been detected in the neonatal period in SA. Repeated screening during infancy of "at risk' groups of babies is recommended.

Breech Presentation↗
PubMed1987

Maternal age and transition to motherhood: prenatal and perinatal assessments.

The purpose of this short-term longitudinal study was to document the contents and consequences of the timing of first birth to two groups of Swedish mothers in respect to biomedical, behavioral, psychological and social variables. Fifty-one primiparous women participated in the study during pregnancy through the first 4 months postpartum. Women were assigned to group dependent upon age: those 20-29 years of age in Group 1; and those 30-39 years of age in Group 2. Methods included standard ethnographic procedures, semi-structured open-ended interviews and pre-coded questionnaires. Infant assessments included the Brazelton examination and the Neonatal Perception Inventory. Results indicated group specific maternal behavioral patterns. Group 2 mothers were more anxious during pregnancy and more likely to regard certain aspects of their transition to motherhood as problematic (e.g. breastfeeding). Additional findings included biomedical variance between groups of infants: the Group 2 infants weighed less and were less healthy than the infants born to younger mothers. Results are discussed in respect to medical precedents and psychological impact as well as the cultural patterning of motherhood.

Adult↗
PubMed2000

Genetic influences on premature parturition in an Australian twin sample.

We investigated possible genetic influences on women's liability to preterm birth, using data from a large sample of Australian female twin pairs. In a 1988-90 questionnaire survey, both members of 905 parous twin pairs (579 monozygotic and 326 dizygotic) reported on whether deliveries had been more than two weeks preterm. Tetrachoric twin pair correlations for first birth were rMZ = 0.20+/-0.11 and rDZ = -0.03+/-0.14, and for any birth were rMZ = 0.30+/-0.08 and rDZ = 0.03+/-0.11. Best-fitting models to data contained only additive genetic influences and individual environmental effects. Heritability was 17% for preterm delivery in first pregnancy, and 27% for preterm delivery in any pregnancy. In the former case, however, we could not reject a model without genetic influences. Although our data did not allow for differentiation of the varying aetiologies of premature parturition, results from this exploratory analysis suggest that further investigation of genetic influences on specific reasons for preterm birth is warranted.

Adult↗
PubMed2006

Risk factors for unintended versus intended rapid repeat pregnancies among adolescents.

PURPOSE: Whereas previous research has elucidated a number of risk factors for rapid repeat pregnancies among adolescents, we sought to assess both established and hypothetical risk factors in the context of the intendedness of the repeat pregnancy. METHODS: The study population, drawn from the 2002 National Survey of Family Growth (NSFG), consisting of women who experienced at least one pregnancy as an adolescent, were interviewed at least 24 months since that pregnancy's resolution and were aged 30 years and younger at the time of the NSFG interview. To evaluate the effect of various predictor variables on the intendedness of a rapid repeat pregnancy, we constructed a polytomous multiple logistic regression model. Outcomes are reported as ratios of odds ratios (ROR) and were calculated using women experiencing an adolescent pregnancy, but not a rapid repeat pregnancy, as the reference group. RESULTS: In the 2002 NSFG, 34% of the adolescents experiencing a rapid repeat pregnancy reported such pregnancies to be intended. Although young age (< or = 15 years) at first conception was associated with a decreased likelihood of an unintended rapid repeat pregnancy, racial/ethnic characteristics as well as characteristics of the teen's mother (educational status and young age of the teen's mother at first birth) were not associated with either intended or unintended rapid repeat pregnancies. Factors found to be associated with an increased likelihood of having an intended repeat pregnancy included an intended first pregnancy, prior poor obstetrical outcome, and having the repeat pregnancy intended by the teen's partner. Being married at the time of second conception was associated with a decreased likelihood of an unintended rapid repeat pregnancy. CONCLUSIONS: Consideration of the intendedness of repeat pregnancies among teenagers could help create more appropriate and effective family planning interventions.

Adolescent↗
PubMed2006

What can be learnt from models of incidence rates?

Models of breast cancer incidence have evolved from the observation by Armitage and Doll in the 1950s that the pattern of incidence by age differs for reproductive cancers from those of other major malignancies. Both two-stage and multistage models have been applied to breast cancer incidence. Consistent across modeling approaches, risk accumulation or the rate of increase in breast cancer incidence is most rapid from menarche to first birth. Models that account for the change in risk after menopause and the temporal sequence of reproductive events summarize risk efficiently and give added insights to potentially important mechanistic features. First pregnancy has an adverse impact on progesterone receptor negative tumors, while increasing parity reduces the risk of estrogen/progesterone receptor positive tumors but not estrogen/progesterone receptor negative tumors. Integrated prediction models that incorporate prediction of carrier status for highly penetrant genes and also account for lifestyle factors, mammographic density, and endogenous hormone levels remain to be efficiently implemented. Models that both inform and reflect the emerging understanding of the molecular and cell biology of carcinogenesis are still a long way off.

Breast Neoplasms↗
PubMed1997

Adolescent childbearing revisited: the age of inner-city mothers at delivery is a determinant of their children's self-sufficiency at age 27 to 33.

OBJECTIVES: Data from recent interviews with 1758 inner-city children, born between 1960 to 1965 and followed with their mothers in the Pathways to Adulthood Study to age 27 to 33 years, were used to address two related questions. 1) Is maternal age, across the reproductive age range, a determinant of child's adult outcome? and 2) Do covariates of maternal age at delivery reduce or eliminate the effect of maternal age on child's adult outcome? METHODS: An intergenerational life course model of development identified significant maternal and child characteristics at birth associated with the child's self-sufficient outcomes in adulthood: education (more than or equal to a high school diploma); financial independence of public support; and delay of first birth until age 20 or older. Bivariate and multiple logistic regression techniques were used to identify independent relationships between dependent and independent variables and to adjust the outcomes to compensate for the effect of possible confounding of maternal age at delivery by maternal education, parity, poverty status, and the child's race and gender. RESULTS: Each covariate was independently associated with maternal age at delivery. Adjustment for their effects reduced, but did not eliminate, the association between maternal age at birth and the child's outcome at age 27 to 33 years. As a group, children of the oldest mothers (>/=25 years of age) had the most favorable outcomes, and those of teenage mothers (<20 years of age) had the least favorable outcomes; 22% of daughters and 6% of sons of the oldest mothers versus 38% and 18%, respectively, of the youngest mothers became teenage parents. CONCLUSION: The mother's age at delivery is an independent determinant of the child's adult status.

Adolescent↗
PubMed2003

Comparison of culling rates among dairy cows grouped on the basis of serologic status for bovine leukemia virus.

OBJECTIVE: To determine the association between serologic status for bovine leukemia virus (BLV) and culling rates by use of survival times in a commercial Holstein dairy herd. DESIGN: Longitudinal study. ANIMALS: 593 milking cows. PROCEDURE: Cattle were tested for antibodies against BLV by use of agar gel immunodiffusion or ELISA 4 times each year from 1989 to 1993 and then annually through 1999. Dates of birth, first calving, and culling or death were obtained from Dairy Herd Improvement Association records. Most cows were enrolled in the study on the date of first calving. Survival times were compared among seropositive, seronegative, and seroconverted cows with the Kaplan-Meier method and a Cox regression model stratified on the basis of year of birth. RESULTS: Complete records were available for 593 of 685 (87%) cattle in the dairy herd during the study period. Median survival time for all cows was 31.7 months. Survival times, which correspond to cull rates, did not differ significantly between seropositive and seronegative cattle, whereas cattle that seroconverted during the study had a significantly longer survival time. Year of birth was positively and significantly associated with survival time. CONCLUSIONS AND CLINICAL RELEVANCE: BLV serologic status was not associated with cull rate as measured by survival time in this dairy herd. This finding is in contrast to results of studies that used survival analysis techniques; our results may influence management decisions concerning BLV.

Animals↗